High Prevalence Of Food Insecurity Research Articles

Youth food insecurity in Ghana and South Africa: Prevalence, socioeconomic correlates, and moderation effect of gender

In sub-Saharan Africa (SSA), food insecurity disproportionately affects adolescents and young adults. However, youth food insecurity in SSA remains understudied. We examined the prevalence, socioeconomic correlates, and moderation effect of gender on youth food insecurity. Our study used a cross-sectional design with data collected from 1,383 and 4,165 youth (aged 15 to 24 years) in South Africa and Ghana, respectively. We performed multiple imputation and analyzed data using multivariable linear regression with clustered-robust standard errors. We conducted moderation tests by adding a 2-way interaction between gender and socioeconomic factors. Results indicated a high prevalence of food insecurity, most notably severe food insecurity. Significant socioeconomic correlates included: age, income, assets, and number of household dependents in Ghana; and race, financial capability skills, number of household shocks, and dwelling type in South Africa. In both countries, we found a moderation effect of gender, which suggests that boys are more food secure when their families have fewer economic resources and that girls are more food secure when their families have greater economic resources. We also observed a moderation effect of gender among younger youth but not among older youth in Ghana. Building household economic resources remains an important pathway to access to adequate food, particularly for girls. In addition, appropriate programs may be those that tailor their components to youths’ developmental stages, living situations, and financial responsibilities.

Food Security Status among Rural Households in Sarpolzahab and its Association with Socio-Economic and Agricultural Factors

Purpose- Food security (FS) is defined as sustainable access to safe and nutritious food for a healthy and active life. The present study was designed to investigate and determine FS status of rural households and the relevant influential factors. It was conducted on 432 rural households in six subdistricts of two districts of Sarpolzahab, West of Iran, in 2016. Design/methodology/approach- The samples were selected using random cluster sampling, and FS status was assessed using United States Department of Agriculture (USDA) household FS questionnaire. Therefore, both socio-economic questionnaire and the household FS questionnaire were completed during a face to face interview. Data were analyzed using the statistical software package SPSS-22. Chi-square, Mann-Whitney, Kruskal-Wallis, and forward multiple logistic regression were used for data analysis. Findings- Prevalence of food insecurity (FI) in all of the surveyed households was 65.3%, and household FS status between the subdistricts had a significant difference (P< 0.01). The results of the study showed that the prevalence of FI in the subdistricts of Posht-Tang and Sarab (83.3% and 76.4%, respectively) was higher than other subdistricts. Number of household’s members, land ownership, education of household’s head, activity status, and household’s income had significantly relationship with household FI (P< 0.01). Practical implications- The high prevalence of FI is a major threat to the abnormal utilization of environmental resources in this realm. Therefore, given the impact of horticultural activities and diverse cultivation on household FS, macro and regional policies should be provided to increase the diversity of products through agroforestry and intercropping. Original/value- This research presents the basic information on the FS status of rural households in Sarpolzahab and some related socio-economic factors the results of which can help planners and managers to implement interventions to improve the FS and welfare of rural households.

Abstract C032: A hospital farm: Using urban agriculture to address nutrition, physical activity, and food insecurity in cancer survivors

Abstract Purpose: Lyndon B Johnson (LBJ) Hospital, a safety net hospital, serves the racially/ethnically diverse (60% Hispanic) and low-socioeconomic status urban population of Harris County, Texas. A number of chronic disease outcomes including cancer are worse than national statistics, of which a major determinant is modifiable behaviors related to energy balance – nutrition and physical activity. A lack of educational opportunities promoting healthy living and a high prevalence of food insecurity further exacerbate the problem. In response, we are building a farm on the campus of LBJ Hospital. We report the current status and future plan of this long-term project. Methods: The 1.5-acre farm broke ground in April 2018. In the context of cancer, the 2 objectives are: 1) to educate survivors about nutrition and gardening as physical activity, and 2) to reduce cancer incidence by engaging the community through educational activities and satellite gardens. We assembled a task force consisting of a medical oncologist, a nurse, dieticians, a farmer and population health experts to design a skill-based curriculum. Funding thus far comes from philanthropy and a competitive grant. Results: A full-time farmer was hired in March 2019 to oversee daily operations and to be the liaison with community groups. To date, 34 raised garden boxes have been built, 1/4-acre main plot is expected to yield 250kg of produce/week in fall/winter 2019, 32 fruit trees have been planted, and a nursery is planned. An evidence-based curriculum has been developed: 5 1-hour learning modules integrate nutrition (culinary techniques, culturally-sensitive recipes) with gardening (basic soil biology, seasonality). A 12-month pilot is to begin in fall/winter 2019. Outpatients with hypertension, diabetes or cancer will be eligible for the class. Participant questionnaires will be administered at baseline, completion and after to assess the primary endpoints of knowledge in nutrition (food groups, labeling, etc.), change in consumption of fruits and vegetables (amount, frequency), change in physical activity level (intensity, duration, frequency), and adoption of gardening as physical activity (duration, frequency). Secondary endpoints will be rate of adherence to medical appointments, change in weight, blood pressure control, change in hemoglobin A1c, and quality of life. Food insecurity will be identified using the Hager 2-item screen. We have solidified partnerships with city government officials and community organizations – local high school, churches, county public health department, local food bank and farms. Conclusion: The hospital-based farm is a multi-level intervention targeting energy balance as a root cause of chronic diseases including cancer and food insecurity as a social determinant of health on the patient and community levels. In the upcoming 12-month pilot, we hypothesize the integrated nutrition/gardening classes will increase consumption of fruits and vegetables and uptake of gardening as physical activity. Citation Format: Hilary Y Ma, Avni P Mody, Janelle Lustgarten, Lisa Ronning, Rebecca Verm, Thomas Garcia-Prats, Michelle Seitzinger. A hospital farm: Using urban agriculture to address nutrition, physical activity, and food insecurity in cancer survivors [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C032.

Applying Community-Based system Dynamics to Address Food Insecurity in Non-Remote Indigenous Populations in Australia

Abstract Objectives There is a growing crisis of hunger and food inequality among Indigenous people in Australia who are increasingly urbanized. They experience substantially higher rates of food insecurity than the general population which impacts on diet-sensitive chronic disease risk and life expectancy. This project aimed to apply systems tools to identify systemic challenges to achieving food security and possible local actions to address the problem in two large Aboriginal communities. Methods A qualitative system dynamics method used group model building (GMB) in two regional and outer urban communities involving participants from Aboriginal Community Controlled Health Services, food relief charities, council, educational groups and some food industry partners in the two local areas. The GMB enabled the participants to consider all the connections between contributing factors, feedback and reinforcing loops to produce a map of food insecurity linked to the local food system. This project was done in collaboration with the Study of Environment of Aboriginal Resilience and Child Health (SEARCH), Australia's largest cohort study into the health of urban Aboriginal children. Results The GMB workshops resulted in causal loop diagrams that mapped the complexities of the food insecurity challenge. The maps highlighted the impact of low incomes and unemployment that influenced the communities’ ability to budget and afford healthy food, thereby leading to a reliance on convenience food outlets. This, in turn, influenced communities’ healthy food preferences, which negatively impacted on food security. Additionally, community education around healthy food choices, meal planning and financial literacy were factors that also directly impacted food security. A distinct loop reflected that a lack of coordination between agencies was leading to duplication and confusion about available food relief services and the ability to access these services. Conclusions These analyses elicited local understanding of the potential levers within the system to address food insecurity in Indigenous people. They are being used to develop community-level workplans to shift the high prevalence of food insecurity and its longer-term impact on preventable chronic disease. Funding Sources This work was funded by the Australian Prevention Partnership Centre and the Sax Institute, Sydney.

Food Insecurity and Associated Demographic, Academic and Health Factors Among Undergraduate Students at a Large Urban University

Abstract Objectives The estimated prevalence of food insecurity among college students is approximately 41%. In response, colleges are implementing food support programs such as campus food pantries and free meals through campus cafeterias. However, there is limited research on prevalence estimates of food insecurity on campuses that have adopted support programs, and if food insecurity on such campuses is associated with known demographic risk factors and health behaviors. The purpose of this study was to assess food insecurity and associated demographics, grade point average (GPA) and health behaviors among undergraduate students attending a 4-year urban university that has a short-term food support program. Methods Undergraduate students (≥18 years of age, NYU) were recruited via email to participate in a Qualtrics survey, which included: 1) the U.S. Household Food Security Survey Module (6-item short form), 2) the Pittsburgh Sleep Quality Index, 3) the Fruit &amp; Vegetable Intake Screener in EATS, and 4) Beverage Questionnaire (BEVQ-15). Demographics, self-reported health status and GPA were assessed. Descriptives, t-tests, Mann-Whitney U, and chi-square analyses were conducted. Results Two hundred and fifty-seven participants completed the survey (age = 20.1 ± 2.5; 82% female; 97.3% full-time). Forty-one % were food insecure. Food insecurity was significantly associated (P &amp;lt; 0.05) with race, ethnicity, health status and GPA. Students who identified as black/African American or Hispanic had an increased risk of food insecurity; conversely those who identified as Asian had a decreased risk. A greater percentage of food insecure students reported a GPA of &amp;lt;3.0 (67 vs. 42%) and fair/poor health (31 vs. 18%). Food insecurity was not associated with fruit/vegetable intake, sugar sweetened beverage consumption, or sleep quality, with the majority of students not meeting recommendations. Conclusions Despite having an on-campus, food support program, our data suggests a high prevalence of food insecurity among students attending a large urban university. Food insecurity was associated with demographic risk-factors, lower GPA and fair/poor health status. For food support programs to be most effective, colleges should consider frequent evaluation of program awareness/accessibility. Funding Sources The Institute of Human Development and Social Change.

High Prevalence of Food Insecurity in Participants Attending Weight Management and Bariatric Surgery Programs.

We evaluated the prevalence and correlates of household food insecurity (HFI) in participants attending weight management and bariatric surgery programs (WMP). We surveyed participants (N = 298) residing with a child and romantic partner from two WMP offering bariatric surgery and medical weight management. We assessed HFI using the Hunger Vital Sign and conducted multivariate logistic regression to assess correlates of HFI. HFI was present in 29.2% of participants. There were increased odds of HFI in participants with lower income and those with three or more children living at home. There was no association with sex, race, program type, education, or BMI. HFI is highly prevalent among participants of WMP. WMP should screen all participants for food insecurity to address this potential barrier to a healthy lifestyle.

Food insecurity in females with phenylketonuria.

SummaryPhenylketonuria (PKU) is a genetic disorder characterized by insufficient metabolism of phenylalanine. Depending on severity, patients follow a low‐phenylalanine diet and may consume medical food (MF) and low‐protein modified foods; dietary and medical treatment can be expensive. This study assessed prevalence of food insecurity (FI), the lack of resources to access enough nutritious food to have an active, healthy life, in females with PKU and examined associations with diet and metabolic control. Participants were recruited from a research‐based camp in 2018. Adult and adolescent modules of the USDA Household Food Security survey were utilized to categorize participants as food secure [high food security (FS) or marginal FS] or food insecure (low FS or very low FS); results were compared to the general U.S. population. Dietary intake via three‐day food records and plasma amino acids were also assessed. Thirty females 11‐58 years of age (mean = 21.4 years) participated. Twelve (40%), including seven adolescents (44%) and five adults (36%), were FI compared to the U.S. prevalence of 11.1%. MF protein intake was significantly lower in those with very low FS compared to high FS and low FS (P = .04). Age and intact protein intake were significantly higher in those with very low FS compared to high FS (P < .05). Our study suggests adolescent and adult females with PKU have a higher prevalence of FI than the general U.S. population. Those with very low FS were older, consumed more dietary phenylalanine and intact protein, and less MF protein. Clinicians should consider screening for FI in patients with PKU.

Food exports and imports of New Zealand in relation to the food-based dietary guidelines.

It has not been reported that previously how much food New Zealand (NZ), population 4.9 million (M), exports and imports in terms of how many people this food would feed if the food-based dietary guidelines (FBDG) were followed. In New Zealand, 40% of adults and 20% of children live in a household with severe to moderate food insecurity. Official data for foods and beverages exported and imported between 2016 and 2018 was obtained from Statistics New Zealand. Harmonised food classifications were matched to either a food group or as discretionary foods or ingredients. Standard serving sizes in grams and number of servings/day from each food group viz; vegetables, 5 servings/day; fruit, 2 servings/day; grains 6 servings/day; meat and protein foods 2.5 servings/day: and dairy 2.5 servings/day were used to determine how many people would be fed each year with the food traded. Together these servings should meet a daily energy intake in the order of 8 MJ. The trade of discretionary foods and ingredients, alcoholic beverages, butter and sugar was also examined. According to the guidelines the quantity of food exported each year by NZ had enough numbers of servings to feed 39 M dairy, 11.5 M meat, seafood and other protein, 2 M vegetables and 10 M fruit day/year. Imports were dominated by grains, enough to feed 9 M six servings a day/year. Total food energy exported and imported was enough to meet the energy requirements for 20 M (30% from butter) and 10 M (27% from sugar), respectively. The high prevalence of food insecurity and obesity in NZ could be partially attributed to the disconnect between the quantity, nutritional quality and diversity of foods imported and exported.

Factors associated with food security in households in the urban area of the state of Tocantins, Northern Brazil.

To evaluate the factors associated with food insecurity in families living in the urban area of Tocantins/Brazil. This is a population-based cross-sectional study conducted in the urban area of 22 municipalities in the 8 microregions of the state. A semi-structured questionnaire was applied to the head of household to obtain socioeconomic and demographic data, and the Brazilian Food Insecurity Scale (EBIA) was used to assess food insecurity at home. The anthropometric assessment of the residents was made by measuring weight, height/length and waist circumference. Multinomial logistic regression was performed to assess the association of food insecurity with individual/household variables, and Pearson's chi-square test was used to compare whether there was a difference in the prevalence of food insecurity between microregions and between families with and without individuals under 18 years. A total of 596 households were evaluated, of which 63.4% were in a food insecurity situation. The final model of the multivariate analysis showed that low head-of-household schooling, low per capita income, receiving social assistance benefits and lack of clean drinking water in the household were associated with food insecurity (p < 0.05). The findings of this study reveal the high prevalence of food insecurity in the families studied and their associated factors, showing the need for local actions and public policies to improve health conditions, education and income of the population, and consequently, improve the scenario of food and nutritional insecurity in the state.

An Evaluation of Food Insecurity and Its Correlates in a Filipino American Study Sample Residing in Clark County, Nevada.

Purpose: Filipino Americans comprise over half of the Asian American population in Clark County, Nevada. Despite their large numbers, food insecurity rates are aggregated with the entire Asian American population. In 2016, 1.6% of Asian American households in Clark County were food insecure, yet, 22% of households reported annual incomes at or below 200% of the federal poverty level. This study aimed to assess the status and correlates of food insecurity specific to Filipino Americans in Clark County, Nevada.Methods: The United States Department of Agriculture (USDA) Short Form Food Security Module was administered among 192 Filipino Americans residing in Clark County, NV. Results were viewed through the theoretical framework of the Social Ecological Model.Results: 27.1% of respondents experienced food insecurity within the past year. Adjusted logistic regression revealed that incomes less than $20,000 (odds ratio [OR]=4.13, 95% confidence interval [CI]: 1.43–11.9), having no health insurance (OR=5.22, 95% CI: 1.67–16.34), and eating mainly American or Western foods (OR=7.3, 95% CI: 1.73–30.77) were significant predictors of food insecurity.Conclusions: A significantly higher prevalence of food insecurity among Filipino American subpopulations, compared to the estimates for Asian Americans in Clark County, suggests the need to disaggregate data for Asian American subgroups. The Social Ecological Model provides greater context to the findings identifying that the intrapersonal and policy level factors were associated with food insecurity among our participants, thus suggesting the need to utilize multilevel interventions to address food insecurity in Filipino Americans. The findings may be utilized to inform future interventions aimed at improving the overall health and food security among Filipino Americans.

Adolescent food insecurity: the special case of Marshallese youth in north-west Arkansas, USA.

Food insecurity is not randomly dispersed throughout the population; rather, there are a number of risk and protective factors shaping both the prevalence and severity of food insecurity across households and sociodemographic populations. The present study examines some of these factors and the role that race and ethnicity among adolescent individuals in north-west Arkansas might play, paying specific attention to a subgroup of Pacific Islanders: the Marshallese. The study uses cross-sectional survey data collected from a self-administered questionnaire of 10th-12th grade students. A city in north-west Arkansas, USA. The number of enrolled students in the selected high school at the time of the survey was 2148. Ten classrooms (116 students) were unable to participate at the time of the survey, making 2032 students eligible to be surveyed. Approximately 22% refused to participate and 105 students were absent from school, yielding a response rate of approximately 78% (n 1493). Marshallese students had a higher prevalence of food insecurity than all other racial and ethnic groups in the study. After controlling for other sociodemographic, risk and protective factors, their odds of food insecurity remained significantly higher than both non-Hispanic White and Hispanic or Latinx students. Adolescent food insecurity among Marshallese students must be made sense of in relation to structural-level determinants that shape the distribution of vital resources such as food across racial, ethnic and foreign-born lines.

An empirical assessment of food security on First Nations in Canada

AbstractUsing data generated from surveys conducted on First Nations throughout Canada, we use regression analysis to examine factors influencing food insecurity. To our knowledge, this is the first time a regression‐based analysis has been conducted to examine food insecurity on First Nations in Canada. As expected, income is inversely related to the likelihood that one reports their household as experiencing food insecurity. In addition, individuals in extremely remote areas are more likely to report their household as experiencing food insecurity. Although traditional food consumption is prevalent, we do not find evidence that it is associated with reductions in the prevalence of self‐reported household food insecurity. We find that gender and mental health are associated with perceived household food insecurity. Although this study is novel, for reasons and limitations detailed in the paper, it should be viewed as an initial effort to establish potential relationships that underscore one of the most important issues facing Canada: the high prevalence of food insecurity in First Nations communities.

Tobacco use increases risk of food insecurity: An analysis of continuous NHANES data from 1999 to 2014

Tobacco use is a major health disparities issue in the United States; it is much more common in less-educated and lower-income groups. These groups also experience a higher prevalence of food insecurity. Previous studies analyzing the association between tobacco use and food insecurity have focused on only cigarettes. We assessed the relationship between food insecurity and use of cigarettes, alternative tobacco products (cigars, electronic cigarettes, smokeless tobacco), any tobacco product, and multiple tobacco products. Using National Health and Nutrition Examination Survey data from 1999 to 2014, we built multinomial logistic regression models predicting degree of food security (i.e., food security, low food security, very low food security) for use of different tobacco product types, any product, and multiple products. After adjustment, use of any product, relative to no use, was significantly associated with increased odds of both food insecurity outcomes: low (adjusted odds ratio (AOR) = 1.2, 95% confidence interval (CI): 1.0–1.4) and very low (AOR = 1.8, 95% CI: 1.6–2.2) food security. In a separate model, single product use, relative to no use, was significantly associated with increased odds of low (AOR = 1.5, 95% CI: 1.3–1.7) and very low (AOR = 2.2, 95% CI: 1.9–2.6) food security. For multiple product use the magnitude of association was higher for very low food security (AOR = 2.7, 95% CI: 1.8–4.0). The significant associations identified here can inform researchers and policymakers developing interventions to prevent tobacco- and food insecurity-related diseases. To be effective in reducing either health risk, interventions may need to target both tobacco use and food insecurity.

AD3 FOOD INSECURE CANCER SURVIVORS ARE MORE LIKELY TO FORGO OR DELAY MEDICAL CARE

The high cost of cancer care leads to financial hardship for many cancer survivors. Food insecurity is an especially alarming problem among cancer survivors given the importance of nutrition on treatment efficacy and disease outcomes. This study assessed the prevalence of food insecurity and its association with delaying or forgoing healthcare among a diverse, population-based sample of cancer survivors. We conducted a cross-sectional survey of individuals age 21-64, diagnosed with stage I-III breast, colorectal, or prostate cancer between 2010 and 2016, identified from the population-based New Mexico Tumor Registry. Participants were administered an English or Spanish paper, online or telephone survey, depending on participant preference. Food insecurity in the year following diagnosis was measured using a validated tool from the US Department of Agriculture’s Core Food Security Module and questions from the Medical Expenditure Panel Survey Experiences with Cancer Supplement were used to ascertain receipt of cancer care. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI). The study included a total of 356 individuals with breast (n=218), colorectal (n=65), or prostate (n=73) cancer (mean age 51y; 70% female; 49% non-Hispanic White; 39% Hispanic or Latino; 39% income <$40,000; 71% privately-insured; 59% ≥1 comorbidity). In the year following diagnosis, 105 (29%) participants were food insecure. Compared to food secure cancer survivors, those reporting food insecurity were more than twice as likely (OR 2.49, 95% CI 1.35-4.58) to delay or forego prescription medications and three times as likely to delay or forego other types of treatment (OR 3.33, 95% CI 1.70-6.52). The high prevalence of food insecurity and its association with foregoing or delaying medical suggest that screening for and intervening on food insecurity may be an important strategy for identifying individuals at risk of nonadherence and reducing disparities in cancer outcomes.

High Prevalence of Food Insecurity and Factors Associated with Haitian Immigrants in Southern Chile.

The objective was to determine the association between sociodemographic factors and food insecurity (FI) in Haitian immigrants in southern Chile. An analytical cross-sectional design was used. The sample consisted of Haitian immigrants residing in Southern Chile, who were recruited from community centers and completed a sociodemographic questionnaire and the Latin-American and Caribbean Food Security Scale. Multivariable analyses were performed to identify factors associated with FI. FI prevalence in the 234 participants was 78%; 60% had severe FI. Having children (OR 3.6; 95% CI 1.6-7.4), limited Spanish proficiency (OR 3.5; 95% CI 1.8-7.3), no access to basic services (OR 2.8; 95% CI 1.2-6.4), and not being a legal permanent resident (OR 2.4; 95% CI 1.1-6.1) were associated with significantly higher odds of FI. Over three-quarters of Haitian immigrants in southern Chile suffer from FI. Tailored intervention strategies are needed to address this major public-health issue, with a special focus on those at highest risk, including families with children, and those with limited Spanish proficiency, no access to basic services, and without legal permanent resident status.

Feeding the Student Body: Unequal Food Insecurity Among College Students

ABSTRACTBackground: A growing but limited body of research has assessed food insecurity among college students. The majority of these studies relied on convenience or nonprobability samples. Purpose: The purpose of this study was to assess the prevalence and odds of food insecurity among undergraduate students. Methods: Online survey data were collected in the spring of 2017 from a random sample of college students attending a 4-year university. A final sample of 378 undergraduate students was included in this study. Pearson's chi-square and logistic regression analyses were used to examine differences in the prevalence and odds of food insecurity across student groups. Results: Nearly a third (32%) of undergraduate students were food insecure. Racial and sexual minorities had a higher prevalence of food insecurity and higher odds of food insecurity. Students who had a background of family financial struggles and who lack housing security had a higher prevalence and higher odds of food insecurity. Discussion: The results are discussed with attention to the role of higher education in reproducing or reducing unequal opportunity in the United States. Translation to Health Education Practice: Certified Health Education Specialists should consider interventions with the differentiated risk of food insecurity in mind.

Determinants of undernutrition among adult patients receiving antiretroviral therapy at Debre Markos referral hospital, Northwest Ethiopia: a case-control study design

BackgroundA complex and negatively reinforcing relationship exists between infection with Human Immune Deficiency Virus (HIV) and malnutrition. HIV-induced immune impairment and its resulting opportunistic infections (OIs) can lead to malnutrition and nutritional deficits, can, in turn, hasten the progression of HIV infection and reduce chances of survival. The determinants of undernutrition among patients receiving antiretroviral therapy (ART) is poorly understood in Ethiopia, despite a high prevalence of food-insecurity that overlaps with a generalized HIV/AIDS epidemic. Therefore, this study aimed to assess determinants of undernutrition among adult patients receiving antiretroviral therapy at Debre Markos Referral Hospital in Northwest Ethiopia.MethodsWe conducted an institution-based, unmatched, case-control study with 636 adult patients receiving antiretroviral therapy. We randomly selected 212 patients with poor nutritional outcomes (cases) and 424 without undernutrition (controls) and then conducted a chart review to collect information on their treatment, socio-economic, and demographic background. Data were analyzed using bivariable and multivariable logistic regression to identify factors associated with under nutrition.ResultsWe found that greater age (AOR = 1.02, 95% CI: 1.01,1.05), fair or poor adherence (AOR = 2.77, 95% CI: 1.40, 5.50 and AOR = 4.72, 95% CI: 1.92, 11.6), and the presence of OIs (AOR = 1.70, 95% CI: 1.12, 2.52), anemia (AOR = 1.81, 95% CI: 1.07, 3.07), or eating problems (AOR = 3.40, 95% CI: 2.27, 5.10), were all independently and positively associated with under nutrition. Starting treatment with a medium or low CD4 count was protective (AOR = 0.61, 95% CI: 0.39, 0.96 and AOR = 0.49, 95% CI: 0.27, 0.88). Having social support (AOR = 0.64, 95% CI: 0.43, 0.95), and having a source of informal care-giving (AOR = 0.48, 95% CI: 0.27, 0.84), reduced the odds of undernutrition.ConclusionOur findings support calls for treating HIV infection early and aggressively, while closely monitoring patients for opportunistic infections that might affect eating and drug side effects that may affect appetite. The role of disclosure, peer-caregivers and age in preventing undernutrition should be explored in future research.

Mental Illness, Not Obesity Status, is Associated with Food Insecurity Among the Elderly in the Health and Retirement Study

Objectives: Food insecurity, limited or uncertain access to adequate nutrition, is an increasingly recognized determinant of health outcomes and is often associated with having obesity. It is unclear, however, if this association persists in elderly populations.Methods: We conducted a cross-sectional study of 2868 participants’ aged 65+ years from the Health and Retirement Study. Multivariate logistic regression was used to assess associations between food insecurity and body mass index, demographic characteristics, psychiatric history, and medical history.Results: Participants with overweight/obesity had a higher prevalence of food insecurity than leaner counterparts, however, weight status was not a significant predictor of food insecurity after multivariate adjustment. Instead, mental illness, current smoking status, and non-White race were all independently associated with food insecurity.Discussion: Beyond financial status, health care providers are encouraged to use these characteristics to identify elderly patients that may be at risk of food insecurity.

Household Food Security among Different Wealth Groups within Uyo Metropolis in Southern Nigeria

Studies done in various states in Nigeria have shown alarming rates of food insecurity among the population. The aim of this study was to determine the prevalence of household food insecurity among different wealth groups in Uyo metropolis, in southern Nigeria and to determine compensatory feeding patterns engaged in by studied food insecure households. This was a cross sectional descriptive study carried out among 249 households of different wealth groups based on the occupational status and educational attainment of the household heads. Data was collected using interviewer administered semi-structured questionnaire and analyzed using SPSS version 20 with a 0.05 level of significance. The prevalence of food insecurity among surveyed households was 89.9% with food insecure 26.5% (without hunger), 30.5% (moderate hunger) and 32.9% (severe hunger). Marital status, socioeconomic class, household size and household income all had statistically significant relationships with food security status (p7 suffered food insecurity with severe hunger. Regarding household income, 48.9% of households with income less than 50,000 naira per month, were food insecure with severe hunger (p<0.05). Coping strategies engaged in by food insecure households included borrowing money from friends, 33.7%, collecting food from friends 26.1% and sending children to work, 8.8%. There was high prevalence of food insecurity among studied households. It is recommended that better educational opportunities be made available to those of the low socioeconomic class, so as to ensure gainful employment. Minimum wage in Nigeria should be increased to ensure increased household income.

The effect of gender on food insecurity among HIV-infected people receiving anti-retroviral therapy: A systematic review and meta-analysis.

BackgroundHIV-infected adults receiving anti-retroviral therapy have a high prevalence of food insecurity in both high- and low-income settings., Women bear an inequitable burden of food insecurity due to lack of control over resources and over household food allocation decision-making. The few studies conducted on the association between food insecurity and gender among HIV-infected adults have inconclusive findings. Therefore, the objective of this systematic review and meta-analysis was to estimate the pooled effect of gender on food insecurity among HIV-infected adults receiving antiretroviral therapy.MethodWe conducted an electronic, web-based search using PubMed, CINAHL, PopLine, MedNar, Embase, Cochrane library, the JBI Library, the Web of Science and Google Scholar. We included studies which reported the association between food insecurity and gender among HIV-infected adults receiving antiretroviral therapy whose age was greater than 18 years. The analysis was conducted using STATA 14 software. A random effects model was used to estimate the pooled effect a 95% confidence interval(CI). Forest plots were used to visualize the presence of heterogeneity. Funnel plots and Egger’s and Begg’s tests were used to check for publication bias.ResultsA total of 776 studies were identified of which seventeen studies were included in the meta-analysis, with a total of 5827 HIV infected adults receiving antiretroviral therapy. We found that the gender of HIV-infected adults receiving anti-retroviral therapy had statistically significant effects on food insecurity. The pooled odds of developing food insecurity among female HIV infected adults receiving anti-retroviral therapy was 53% higher than male HIV infected adults (OR: 1.53, 95% CI: 1.29, 1.83). Our analysis indicate the findings of studies conducted in the high-income countries showed weakest associations between gender and food insecurity than those conducted in low- and middle-income countries.ConclusionOur systematic review and meta-analysis showed statistically significant effect of gender on food insecurity among HIV-infected adults receiving anti-retroviral therapy in which odds of food insecurity was higher among female HIV infected adults compared to male HIV-infected adults. These findings suggest that the need to include within food and nutrition interventions for HIV-infected adults receiving antiretroviral treatment, culture- and context-specific gender-based policies to address the sex/gender related vulnerability to food insecurity.